LEVEL II - NUR 195
ESSENTIAL INTRAPARTUM AND
NEWBORN CARE (EINC)
PRACTICE SESSION CHECKLIST
Name of Student: _________________________________________
Section: _________________________________________________
School Year & Term: _______________________________________
Date: ___________________________________________________
DEMONSTRATED
PROCEDURE REMARKS
YES NO
Inside Delivery Room (2nd stage of labor)
1. Assess for complete cervical dilation. - Progress of labor is measured by descent
of the fetal head through the birth canal. - Uterine contractions every 2 to 3
minutes, lasting 60 to 75 seconds, and are of strong intensity
2. Explain to the patient that she is being transferred to the Delivery room table,
while maintaining privacy.
3. Take initial vital signs.
4. Check the good place, light & complete equipment.
5. Check temperature in the DR area to be 25-280 Celsius; eliminate air dropped.
6. Assemble equipment:
a. gloves
b. dry linen/towels
c. drapes
d. bonnet
e. oxytocin injection
f. syringes: 3 mL
g. 1 straight Kelly
h. scissors/Metzenbaum
i. 2 kidney basins
j. gauze/abdominal pack
k. Peri-bottle (for Flushing)
l. newborn tray: plastic cord clamp, identification band, suction catheter,
towels.
7. Place mother in lithotomy position.
8. Prepare a clear, clean newborn resuscitation area on a firm flat surface (Radiant
warmer/ bassinet with drop light).
9. Instruct mother to bear down during contraction & relax in- between. Second
stage breathing (if breath holding while pushing is used, the open glottis
method or limiting breath holding to less than 6 to 8 seconds should be done)
10. Drape clean, dry linen over the woman’s abdomen or arms in preparation for
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drying the baby.
11. Guide (assist / actual) the delivery of the baby's head and the subsequent
expulsion of the fetal body.
(3rd stage of labor)
12. Announce the sex and time of delivery. “Baby boy/girl at time”
FIRST 30 SECONDS
13. Wipe the face of the baby to remove excess secretion.
14. Thoroughly dry baby for at least 30 seconds from the face and head, going to the
trunk and extremities while performing a quick check for breathing.
1-3 MINUTES
15. Remove the wet cloth.
16. Performs and interprets APGAR scoring correctly.
a. Immediately after delivery.
b. After 5 minutes.
17. Place the baby in skin-to skin contact on the mother’s abdomen or chest.
18. Exclude a 2nd baby by palpating the abdomen in preparation for giving oxytocin
19. Give IM oxytocin within one minute of baby’s birth after wiping the soiled gloves
with the wet cloth. Disposed of wet cloth properly.
20. Ensures proper identification of newborn (Name tag: Complete name of the
mother, date and time of delivery, sex, and name of attending physician).
According to institution policy.
21. Remove 1st set of gloves after positioning the baby for cord clamping.
22. Palpate umbilical cord to check for pulsations.
23. After pulsations stopped, clamped the cord using the plastic clamp 2cm from the
base.
24. Apply a second clamp at 5 cm distally to the first one. Cut near the plastic (not
midway) using a scissor.
25. Wait for spontaneous expulsion of placenta otherwise deliver the placenta by
controlled cord traction (CCT). One hand puts gentle traction on the cord while
the other presses the anterior surface of the uterus backward (Brandt-
Andrew’s maneuver).
26. Examine the placenta for completeness and abnormalities (Schultze or Duncan
presentations)
27. Re – assess blood pressure.
28. Massage the uterus until it is firm.
29. Prepare for suturing if episiotomy is done. Inspect the lower vagina and
perineum for lacerations.
30. Clean the mother: flushed the perineum and applied perineal pad/napkin/cloth.
31. Check the baby’s color and breathing; checked that mother was comfortable,
uterus contracted.
32. Dispose the placenta in a leak -proof container or biohazard receptacle.
33. Gather all instruments used and sponges, keep in the proper cleaning area.
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34. Advice mother to maintain skin-to-skin contact. Baby should be prone on the
mother's chest/in between the breasts with the head turned to one side.
35. Perform hand hygiene and document.
15-90 MINUTES
36. Advice mother to observe for feeding cues and cited examples of feeding cues.
37. Support mother instructed her on positioning and attachment.
38. Wait for FULL BREASTFEED to be completed.
Inside Nursery Room
39. Assemble equipment:
a. Infant Radiant Warmer (Droplight and baby’s bassinet)
b. Suction Machine, Suction Catheter French 6 to 8 sizes
c. Weighing Scale, tape measure
d. Sterile Gloves
e. Digital Thermometer
f. Vitamin K
g. Ophthalmic Ointment
h. Lukewarm Water, Soap and Baby Oil Cotton balls, Surgical brush
i. Alcohol 70%
j. Complete Newborn Clothes (mittens, booties, bonnet, singlet,
sleepsuit)
k. Newborn Diaper
l. Blanket
40. Perform physical assessment.
41. Takes anthropometric measurements including weight, height, head, chest,
abdominal circumference.
a. Measure head circumference: Slide the tape measure under the
neonate’s head at the occiput and draw the tape around snugly just
above the eyebrows. Normal neonatal head circumference is 13 to 14
inches (33 to 35.5 cm). Cranial molding or caput succedaneum from a
vaginal delivery may affect this measurement.
b. Measure chest circumference: Place tape under the back, wrapping it
snugly around the chest at the nipple line, and keeping the back and
front of the tape level. Take the measurement after the neonate
inspires and before he begins to exhale. Normal neonatal chest
circumference is 12 to 13 inches (30.5 to 33 cm).
c. Measure head-to-heel length: Fully extend the neonate’s legs with the
toes pointing up. Measure the distance from the heel to the top of the
head. A length board may be used, if available. Normal length is 18 to
21 inches (46 to 53 cm).
d. Weight: Remove the diaper and place the neonate in the middle of the
scale tray. Average weight is 2.8 to 3kg (6 to 6.6lbs.) Always weigh
neonate before feeding and ensure that the scale is balanced. Take the
neonate’s weight at the same time each day, if possible.
e. Measure abdominal girth: Place the tape measure around the
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abdominal area just above the umbilicus, making sure to keep the tape
level.
42. Advise OPTIONAL/DELAYED bathing of baby (and was able to explain the
rationale)
43. Perform cord dressing aseptically:
a. Wear sterile gloves.
b. Disinfects the area properly according to hospital policy. Cleanse the
umbilical cord area using a circular motion and alcohol 70%.
c. Begin the circular motion from the umbilicus and move towards the
end of the umbilical cord.
d. Checks for the presence of 2 arteries and 1 vein.
44. Dress the newborn properly.
45. Applies CREDE’s prophylaxis on the eyes.
a. Shield the neonate’s eyes from direct light and tilt his head slightly to
the side of the intended treatment.
b. Using your nondominant hand, gently raise the neonate’s upper eyelid
with your index finger and pull the lower eyelid down with your thumb.
c. Using your dominant hand, instill a 1- to 2-cm ribbon of ointment along
the lower conjunctival sac, from the inner canthus to the outer
canthus.
d. Repeat the steps with the other eye.
46. Administer Inj. Vitamin K and (Hepatitis B and BCG)
a. Prepare the prescribed dose of vitamin K, appropriate size syringe with
a 25G,5⁄8 safety needle, cotton ball with saline and dry gauze.
b. Prepare 1 to 2 mg of Vitamin K.
c. Locate lateral anterior thigh or vastus lateralis muscle and select an
appropriate site for injection (Intramuscular)
47. Perform swaddling (According to Agency Policy). Advise breastfeeding per
demand.
48. In the first hour, check the baby's breathing and color and check the mother’s
vital signs and massage the uterus every 15 minutes.
49. In the second hour: check mother-baby dyad every 30 minutes to 1 hour.
50. Perform hand hygiene and complete documentation.
Rating Scale:
Excellent: 9-10 points
Very Satisfactory: 7-8 points
Satisfactory: 6 points
Poor: 5 points and below (for remedial)
Total: ____________________________________
Preceptor: ________________________________
Signature Over Printed Name
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